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The intergenerational health, social care, and justice system contacts associated with household substance misuse in Wales

Hywel Evans Orcid Logo, Ian Farr, Grace Bailey Orcid Logo, Gareth Davies Orcid Logo, Josh Dixon Orcid Logo, Sam Fallick Orcid Logo, Joanne Maimaris, Columbus Ohaeri Orcid Logo, Olabambo Oluwasuji, Ryan Phillips, Matthew Skermer, Delyth James Orcid Logo, Josie Smith Orcid Logo

International Journal of Population Data Science, Volume: 11, Issue: 1

Swansea University Authors: Hywel Evans Orcid Logo, Ian Farr, Grace Bailey Orcid Logo, Gareth Davies Orcid Logo

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DOI (Published version): 10.23889/ijpds.v11i1.2948

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BackgroundHousehold substance misuse (SM) is associated with child deprivation and worse physical and mental health. This study utilised linked healthcare, justice, and children's social care data in Wales for the first time, to create a reusable cohort of households that experience substance m...

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Published in: International Journal of Population Data Science
ISSN: 2399-4908
Published: Swansea University 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71264
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This study utilised linked healthcare, justice, and children's social care data in Wales for the first time, to create a reusable cohort of households that experience substance misuse (SMHH).MethodsUsing the SAIL Databank, a population-scale retrospective electronic cohort (e-cohort) was created to perform a cross-sectional analysis of SM-related health and criminal justice events during 2011-2019 for adults and children in SMHH, which were compared with the rest of the population using period prevalence ratios (PR) and 95% confidence intervals (CI). Other variables included demographics, children's social care, healthcare, and SM-related criminal court cases.ResultsThere were 776,366 children and 1,032,088 adults, where 83,558 children (11%) lived in SMHH, and 48,398 (5%) of adults who lived with a child had a SM event. Children in SMHH had a 133% higher prevalence of referral to SM treatment (PR = 2.33, CI: 2.23-2.43), and a SM-related criminal case was 42% more prevalent (PR = 1.42, CI: 1.30-1.55) during the period. Notably, the prevalence of SMHH children receiving care and support was 300% higher (PR = 4.00, CI: 3.92-4.08), and self-harm was 78% more prevalent (PR = 1.78, CI: 1.71-1.86).ConclusionSMHH children experience significant disparities, including higher deprivation, adverse birth outcomes, mental health issues, social care involvement, and SM-related criminal justice prosecutions. Evidence-based interventions and policy are needed to support adults and children in SMHH to mitigate the intergenerational impact.</abstract><type>Journal Article</type><journal>International Journal of Population Data Science</journal><volume>11</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher>Swansea University</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2399-4908</issnElectronic><keywords>substance misuse; substance use harms; harmful substance use; drug; alcohol; intergenerational; data linkage; justice</keywords><publishedDay>14</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2026</publishedYear><publishedDate>2026-01-14</publishedDate><doi>10.23889/ijpds.v11i1.2948</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Other</apcterm><funders>This research received funding from the Better Outcomesthrough Linked Data (BOLD) programme, a UK Governmentdata-linking programme which aims to improve theconnectedness of government data in England and Wales.It was funded as part of the ‘Ministry of Justice BetterOutcomes through Linked Data (BOLD) - SubstanceMisuse Demonstrator Pilot (Wales) 2023/2024’ (no grantnumber).</funders><projectreference/><lastEdited>2026-02-11T10:43:04.5679363</lastEdited><Created>2026-01-18T08:16:45.5367446</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Hywel</firstname><surname>Evans</surname><orcid>0000-0001-6745-4187</orcid><order>1</order></author><author><firstname>Ian</firstname><surname>Farr</surname><order>2</order></author><author><firstname>Grace</firstname><surname>Bailey</surname><orcid>0000-0003-4646-3134</orcid><order>3</order></author><author><firstname>Gareth</firstname><surname>Davies</surname><orcid>0000-0001-9005-1618</orcid><order>4</order></author><author><firstname>Josh</firstname><surname>Dixon</surname><orcid>0009-0009-9328-6522</orcid><order>5</order></author><author><firstname>Sam</firstname><surname>Fallick</surname><orcid>0009-0000-9811-7300</orcid><order>6</order></author><author><firstname>Joanne</firstname><surname>Maimaris</surname><order>7</order></author><author><firstname>Columbus</firstname><surname>Ohaeri</surname><orcid>0000-0002-6016-3245</orcid><order>8</order></author><author><firstname>Olabambo</firstname><surname>Oluwasuji</surname><order>9</order></author><author><firstname>Ryan</firstname><surname>Phillips</surname><order>10</order></author><author><firstname>Matthew</firstname><surname>Skermer</surname><order>11</order></author><author><firstname>Delyth</firstname><surname>James</surname><orcid>0009-0007-4572-9689</orcid><order>12</order></author><author><firstname>Josie</firstname><surname>Smith</surname><orcid>0000-0002-7671-104x</orcid><order>13</order></author></authors><documents><document><filename>71264__36220__903f65522f3d43499bdd359910360220.pdf</filename><originalFilename>71264.VoR.pdf</originalFilename><uploaded>2026-02-11T10:39:57.2605474</uploaded><type>Output</type><contentLength>2838238</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© The Authors. 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spelling v2 71264 2026-01-18 The intergenerational health, social care, and justice system contacts associated with household substance misuse in Wales 73cc98a5b8e4122fdfcee5d88208b0b7 0000-0001-6745-4187 Hywel Evans Hywel Evans true false 3c02e7e9c2b064ee3e96e83b9777dde4 Ian Farr Ian Farr true false 1e09a407fca9e8047e7738b18d381130 0000-0003-4646-3134 Grace Bailey Grace Bailey true false 98490239b86cc892a382416d048cdb3c 0000-0001-9005-1618 Gareth Davies Gareth Davies true false 2026-01-18 MEDS BackgroundHousehold substance misuse (SM) is associated with child deprivation and worse physical and mental health. This study utilised linked healthcare, justice, and children's social care data in Wales for the first time, to create a reusable cohort of households that experience substance misuse (SMHH).MethodsUsing the SAIL Databank, a population-scale retrospective electronic cohort (e-cohort) was created to perform a cross-sectional analysis of SM-related health and criminal justice events during 2011-2019 for adults and children in SMHH, which were compared with the rest of the population using period prevalence ratios (PR) and 95% confidence intervals (CI). Other variables included demographics, children's social care, healthcare, and SM-related criminal court cases.ResultsThere were 776,366 children and 1,032,088 adults, where 83,558 children (11%) lived in SMHH, and 48,398 (5%) of adults who lived with a child had a SM event. Children in SMHH had a 133% higher prevalence of referral to SM treatment (PR = 2.33, CI: 2.23-2.43), and a SM-related criminal case was 42% more prevalent (PR = 1.42, CI: 1.30-1.55) during the period. Notably, the prevalence of SMHH children receiving care and support was 300% higher (PR = 4.00, CI: 3.92-4.08), and self-harm was 78% more prevalent (PR = 1.78, CI: 1.71-1.86).ConclusionSMHH children experience significant disparities, including higher deprivation, adverse birth outcomes, mental health issues, social care involvement, and SM-related criminal justice prosecutions. Evidence-based interventions and policy are needed to support adults and children in SMHH to mitigate the intergenerational impact. Journal Article International Journal of Population Data Science 11 1 Swansea University 2399-4908 substance misuse; substance use harms; harmful substance use; drug; alcohol; intergenerational; data linkage; justice 14 1 2026 2026-01-14 10.23889/ijpds.v11i1.2948 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Other This research received funding from the Better Outcomesthrough Linked Data (BOLD) programme, a UK Governmentdata-linking programme which aims to improve theconnectedness of government data in England and Wales.It was funded as part of the ‘Ministry of Justice BetterOutcomes through Linked Data (BOLD) - SubstanceMisuse Demonstrator Pilot (Wales) 2023/2024’ (no grantnumber). 2026-02-11T10:43:04.5679363 2026-01-18T08:16:45.5367446 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Hywel Evans 0000-0001-6745-4187 1 Ian Farr 2 Grace Bailey 0000-0003-4646-3134 3 Gareth Davies 0000-0001-9005-1618 4 Josh Dixon 0009-0009-9328-6522 5 Sam Fallick 0009-0000-9811-7300 6 Joanne Maimaris 7 Columbus Ohaeri 0000-0002-6016-3245 8 Olabambo Oluwasuji 9 Ryan Phillips 10 Matthew Skermer 11 Delyth James 0009-0007-4572-9689 12 Josie Smith 0000-0002-7671-104x 13 71264__36220__903f65522f3d43499bdd359910360220.pdf 71264.VoR.pdf 2026-02-11T10:39:57.2605474 Output 2838238 application/pdf Version of Record true © The Authors. Open Access under CC BY 4.0. true eng https://creativecommons.org/licenses/by/4.0/deed.en
title The intergenerational health, social care, and justice system contacts associated with household substance misuse in Wales
spellingShingle The intergenerational health, social care, and justice system contacts associated with household substance misuse in Wales
Hywel Evans
Ian Farr
Grace Bailey
Gareth Davies
title_short The intergenerational health, social care, and justice system contacts associated with household substance misuse in Wales
title_full The intergenerational health, social care, and justice system contacts associated with household substance misuse in Wales
title_fullStr The intergenerational health, social care, and justice system contacts associated with household substance misuse in Wales
title_full_unstemmed The intergenerational health, social care, and justice system contacts associated with household substance misuse in Wales
title_sort The intergenerational health, social care, and justice system contacts associated with household substance misuse in Wales
author_id_str_mv 73cc98a5b8e4122fdfcee5d88208b0b7
3c02e7e9c2b064ee3e96e83b9777dde4
1e09a407fca9e8047e7738b18d381130
98490239b86cc892a382416d048cdb3c
author_id_fullname_str_mv 73cc98a5b8e4122fdfcee5d88208b0b7_***_Hywel Evans
3c02e7e9c2b064ee3e96e83b9777dde4_***_Ian Farr
1e09a407fca9e8047e7738b18d381130_***_Grace Bailey
98490239b86cc892a382416d048cdb3c_***_Gareth Davies
author Hywel Evans
Ian Farr
Grace Bailey
Gareth Davies
author2 Hywel Evans
Ian Farr
Grace Bailey
Gareth Davies
Josh Dixon
Sam Fallick
Joanne Maimaris
Columbus Ohaeri
Olabambo Oluwasuji
Ryan Phillips
Matthew Skermer
Delyth James
Josie Smith
format Journal article
container_title International Journal of Population Data Science
container_volume 11
container_issue 1
publishDate 2026
institution Swansea University
issn 2399-4908
doi_str_mv 10.23889/ijpds.v11i1.2948
publisher Swansea University
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description BackgroundHousehold substance misuse (SM) is associated with child deprivation and worse physical and mental health. This study utilised linked healthcare, justice, and children's social care data in Wales for the first time, to create a reusable cohort of households that experience substance misuse (SMHH).MethodsUsing the SAIL Databank, a population-scale retrospective electronic cohort (e-cohort) was created to perform a cross-sectional analysis of SM-related health and criminal justice events during 2011-2019 for adults and children in SMHH, which were compared with the rest of the population using period prevalence ratios (PR) and 95% confidence intervals (CI). Other variables included demographics, children's social care, healthcare, and SM-related criminal court cases.ResultsThere were 776,366 children and 1,032,088 adults, where 83,558 children (11%) lived in SMHH, and 48,398 (5%) of adults who lived with a child had a SM event. Children in SMHH had a 133% higher prevalence of referral to SM treatment (PR = 2.33, CI: 2.23-2.43), and a SM-related criminal case was 42% more prevalent (PR = 1.42, CI: 1.30-1.55) during the period. Notably, the prevalence of SMHH children receiving care and support was 300% higher (PR = 4.00, CI: 3.92-4.08), and self-harm was 78% more prevalent (PR = 1.78, CI: 1.71-1.86).ConclusionSMHH children experience significant disparities, including higher deprivation, adverse birth outcomes, mental health issues, social care involvement, and SM-related criminal justice prosecutions. Evidence-based interventions and policy are needed to support adults and children in SMHH to mitigate the intergenerational impact.
published_date 2026-01-14T10:43:06Z
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